Permit 1739 Beach Ave Temp Pole 2012 CITY OF ATLANTIC BEACH
800 SEMINOLE ROAD
ATLANTIC BEACH, FL 32233
INSPECTION PHONE LINE 247-5814
Application Number . . . . . 12-00000194 Date 2/16/12
Property Address . . . . . . 1739 BEACH AVE
Application type description ELECTRIC ONLY
Property Zoning . . . . . . . TO BE UPDATED
Application valuation . . . . 0
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Application desc
temp pole
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Owner Contractor
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CLEMENTS UNITED ELECTRIC COMPANY OF
1739 BEACH AVENUE JACKSONVILLE
ATLANTIC BEACH FL 32233 5716 ST. AUGUSTINE ROAD
JACKSONVILLE FL 32207
(904) 731-4210
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Permit . . . . . . ELECTRICAL PERMIT
Additional desc . . TEMP POLE
Permit Fee . . . . 90 . 00 Plan Check Fee . 00
Issue Date . . . . Valuation . . . . 0
Expiration Date . . 8/14/12
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Other Fees . . . . . . . . . STATE ELEC DCA SURCHARGE 2 . 00
STATE ELEC DBPR SURCHARGE 2 . 00
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Fee summary Charged Paid Credited Due
----------------- ---------- ---------- ---------- ----------
Permit Fee Total 90 . 00 90 . 00 . 00 . 00
Plan Check Total . 00 . 00 . 00 . 00
Other Fee Total 4 . 00 4 . 00 . 00 . 00
Grand Total 94 . 00 94 . 00 . 00 . 00
PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA
BUILDING CODES.
ELECTRICAL PERMIT APPLICATION
CITY OF ATLANTIC BEACH
800 Seminole Rd,Atlantic Beach' FL 32233
Ph(904) 247-5826 Fax (904)247-5845
JOB ADDRESS: 9 —6 t a C/� /q V.4— . - PERMIT it
JEA INFORMATION REQUIRED ON ALL PERMITS _&0 AMPS �2'/0 VOLTS PHASE
,VAL UE OF WORK$
TCSER F� Underground Underground up Pole
e
v k�
ORVesiti4�e)Service
00-100 amps 0101-150amps 0 151-200amps 0—amps of Meters
0 Commercial(Main)Service
00-100 amps 0101-150amps 0 151-200amps 0______amps OCT Service amps
Conductor Type Size
OMulti-Family(Main)Service
00-100 amps 0101-150amps 0 151-200amps 0—amps 4 of Unit Meters
Vemporary Pole 0 /0 0 amps
SERVICE UPGRADE 0 CT Service amps
Tl �
NEW FEEDER(ADDITIONS,ACCESSORY STRUCTURES,ETC.) amps
0100amps 0150amps 0200amps 0 amps OCT Service
ADDITIONS,REMODELS,REPAIRS,BUILD-OUTS,ACCESSORY STRUCTURES,ETC.
Outlets/Switches: 0-30amps 31-100amps 10 1-200amps y
Appliances: —0-30amps 3 1-1 00amps 10 1-200amps
A/C Circuits: 0-60amps 61-100amps
Heat Circuits: 4 circuits
Number of Lighting Outlets, Including Fixtures:
OTHER ELECTRICAL PROJECTS hp
E]SwimmingPool OSign 0 Smoke Detectors_Qty OTransformers KVA 0 Motors
FIRE ALARM SYSTEM (Requires 3 sets of plans&Fire Alarm Checklist)
Qty_volts/amps VALUE OF WORK$
REPAIRSMSCELLANEOUS
OReplace Burnt/Damaged Meter Can 0 Safety Inspection OPanel Change 0014 to UG
44 �0 a JA"X
00ther:
Permit bec s void if work does not commence within a six month period or work is suspended or abandoned for six months. I hereby certify that I have
read this application and know the same to be true and correct. All provisions of laws and ordinances governing this work will be complied with whether
specified or not The permit does not give authority to violate the provisions of any other state or local law regulation construction or the performance of
construction. Inol-C.1'e-1 J---�
Property Owners Name ?0 P.0 q 01M/11 Phone Number q 9 3- 99 q7 C'4-`�4
. ) I / -73)
Electrical Company U-f%I Elfc�fr__'L 00 6 4'k, —Office Phone V21,�P Fax-73) --7�r,3 /L
Co.Address: 5-7/(P Iq vo) City 3 e-CAfol?,,I)k State rL Zipjp_;� a -?
: Gr� e Cgrtification/Registration 1—�C00'00'3 YI/
License Holder(Print) Stat
r
Notarized Signature of License Holder
20
A b fore me thii
�el MARILYM E.TARPLEY Sworn and'subscribed day of FeArLtor
WCOWSSIONM875577
zl EXPIRES:March 30,2013
Bonded Thru Notary PoWc Undwwriters Signature of Notary Publicw'-�'�� _T" A
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